Bayesian analysis of geographical variation in the incidence of Type I diabetes in Finland

Aims/hypothesis. In Finland, the incidence of Type I (insulin-dependent) di abetes mellitus among children aged 14 years or under is the highest in the world. The increase in incidence is approximately 3% per year. A marked ge ographical variation in incidence was reported in Finland during the late 1 980s. Our aim was to explore the most recent regional pattern in incidence of Type I diabetes in Finland. Methods. Data on the nationwide incidence of childhood diabetes in Finland was obtained from the Prospective Childhood Diabetes Registry for the perio ds 1987-1991 and 1992-1996. Population data was obtained from the National Population Registry. The geographical pattern of incidence was studied appl ying a Bayesian hierarchical approach and Geographical Information Systems. The inferences from the data was based on the estimated geographical inten sity of diabetes. Results. There was a clear evidence of geographic variation for the risk of childhood diabetes during the entire 10-year period. The high-risk areas w ere found in the wide belt crossing the central part of Finland. Comparison of the estimated intensity of diabetes between the two 5-year periods show ed that the geographical pattern of diabetes risk has changed over time. Ou r analyses also confirmed the existence of a few persistent high-risk and l ow-risk areas in Finland. Conclusion/interpretation. The finding of high-risk areas of childhood Type I diabetes suggests that specific genetic or environmental risk factors ha ve become greater in certain geographic locations in Finland.